N Sotelo Cruz1, A M Calderón de la Barca2, J G Hurtado Valenzuela3. 1. Departamento de Medicina y Ciencias de la Salud, Universidad de Sonora, Hermosillo, Sonora, México. Electronic address: nsotelo51@gmail.com. 2. Área de Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C. (CIAD), Hermosillo, Sonora, México. 3. Hospital Infantil del Estado de Sonora, Hermosillo, Sonora, Universidad Estatal de Sonora, Hermosillo, Sonora, México.
Abstract
BACKGROUND: Celiac disease (CD) is an autoimmune enteropathy induced by dietary wheat gluten that can have serious consequences if not diagnosed and treated early. It is important to be familiar with other alterations associated with gluten ingestion due to the multiplicity of clinical presentations. OBJECTIVES: To describe the most common CD presentation patterns and alterations associated with gluten in children from the northwest region of Mexico, with an incipient knowledge of its prevalence. PATIENTS AND METHODS: Age, sex, family history, and gastrointestinal and extraintestinal symptoms were recorded in 24 patients within the time frame of 2006 to 2010. Biochemical and hematologic data were collected. Anti-gliadin and anti-transglutaminase antibodies were analyzed in all the cases, and haplotypes (HLA-DQ2/DQ8) and duodenal biopsy were evaluated in some of the cases. RESULTS: Of the 24 patients (14 girls and 10 boys), 13 presented with typical CD with symptoms of poor gastrointestinal absorption; 7 patients with a mean age of 5 years presented with atypical CD; 2 had disease onset with gastrointestinal and extraintestinal (neurologic) problems; and 2 with other gluten-related disorders. All of the patients had positive serology; 11/15 presented with HLA-DQ2/DQ8 and 4 with at least one allele; damaged mucosa was observed in the 6 biopsies taken. A third of the patients were anemic, 6 presented with an albumin value of<3.5g/dL, and 4 with mineral deficiencies. A total of 83% of the patients improved with a gluten-free diet. CONCLUSIONS: The presentation patterns were: 1) typical CD, 2) atypical CD, 3) CD with gastrointestinal and extraintestinal (neurologic) symptoms, and 4) gluten-related disorders other than CD.
BACKGROUND:Celiac disease (CD) is an autoimmune enteropathy induced by dietary wheat gluten that can have serious consequences if not diagnosed and treated early. It is important to be familiar with other alterations associated with gluten ingestion due to the multiplicity of clinical presentations. OBJECTIVES: To describe the most common CD presentation patterns and alterations associated with gluten in children from the northwest region of Mexico, with an incipient knowledge of its prevalence. PATIENTS AND METHODS: Age, sex, family history, and gastrointestinal and extraintestinal symptoms were recorded in 24 patients within the time frame of 2006 to 2010. Biochemical and hematologic data were collected. Anti-gliadin and anti-transglutaminase antibodies were analyzed in all the cases, and haplotypes (HLA-DQ2/DQ8) and duodenal biopsy were evaluated in some of the cases. RESULTS: Of the 24 patients (14 girls and 10 boys), 13 presented with typical CD with symptoms of poor gastrointestinal absorption; 7 patients with a mean age of 5 years presented with atypical CD; 2 had disease onset with gastrointestinal and extraintestinal (neurologic) problems; and 2 with other gluten-related disorders. All of the patients had positive serology; 11/15 presented with HLA-DQ2/DQ8 and 4 with at least one allele; damaged mucosa was observed in the 6 biopsies taken. A third of the patients were anemic, 6 presented with an albumin value of<3.5g/dL, and 4 with mineral deficiencies. A total of 83% of the patients improved with a gluten-free diet. CONCLUSIONS: The presentation patterns were: 1) typical CD, 2) atypical CD, 3) CD with gastrointestinal and extraintestinal (neurologic) symptoms, and 4) gluten-related disorders other than CD.
Authors: Karen Lizzete Ramírez-Cervantes; José María Remes-Troche; María Del Pilar Milke-García; Viridiana Romero; Luis F Uscanga Journal: BMC Gastroenterol Date: 2015-01-22 Impact factor: 3.067
Authors: Jose F Garcia-Mazcorro; Xaira Rivera-Gutierrez; Orestes De Jesus Cobos-Quevedo; Peter Grube-Pagola; Arturo Meixueiro-Daza; Karina Hernandez-Flores; Francisco J Cabrera-Jorge; Hector Vivanco-Cid; Scot E Dowd; Jose M Remes-Troche Journal: Nutrients Date: 2018-11-02 Impact factor: 5.717
Authors: Hasan M Isa; Eman Farid; Jaafar J Makhlooq; Afaf M Mohamed; Jumana G Al-Arayedh; Fawzeya A Alahmed; Shima Medani Journal: Clin Exp Pediatr Date: 2020-10-17